EVALUATION OF CLINICOPATHOLOGICAL FEATURES AND SURGICAL RESULTS IN THYROID FINE NEEDLE ASPIRATION BIOPSY OF BETHESDA 3 CATEGORY PATIENTS : A TERTIARY HOSPITAL EXPERIENCE

Year 2024, Volume: 9 Issue: 2, 66 - 70, 16.08.2024

Mehmet Baykan Saliha Karagöz Eren Mehmet Patmano Tamer Ertan

https://doi.org/10.55694/jamer.1438765

Abstract

Aim:
Thyroid nodules are a very common pathology worldwide. Thyroid fine needle biopsy (FNAB) is a very important diagnostic tool in the diagnosis of thyroid malignancies. However, the Bethesda System used to classify the results cannot classify patients with atypia/follicular lesion of undetermined significance (AUS/FLUS) nodule as benign or malignant. Therefore, some risk factors need to be known in order to determine the best treatment for these patients. In this study, we aimed to evaluate our patients who were operated on due to AUS/FLUS.
Material and Methods:
We retrospectively examined 144 patients whose cytology was AUS/FLUS and who were operated on, among 1298 patients who underwent FNAB between September 2018 and December 2021.
Result:
The histopathology of 58 (40%) of the 144 patients who underwent FNAB, whose cytology was AUS/FLUS and who were operated on, was malignant. When we compared the ultrasound image features of thyroid nodules with malignant histopathology results, it was determined that hypoechoic, microcalcification, irregular border and hypervascularity images were significant in terms of malignancy (p <0.005).
Conclusion:
The malignancy rate in surgically confirmed nodules was 40% in this study, and this rate was found to be high according to the Bethesda classification. We think that if patients have hypoechoic structure, microcalcification, irregular edges and hypervascular nodules as a result of FNAB histopathological result with AUS/FLUS, surgical treatment should be considered.

Keywords

Atypia of undetermined significance/ follicular lesion of undetermined significance, Fine needle aspiration biopsy, Malignancy, Thyroid nodule

TİROİD İNCE İĞNE ASPİRASYON BİYOPSİSİNDE BETHESDA 3 KATEGORİSİNDEKİ HASTALARIN KLİNİKOPATOLOJİK VE CERRAHİ SONUÇLARININ DEĞERLENDİRİLMESİ: ÜÇÜNCÜ BASAMAK HASTANE DENEYİMİ

Abstract

Amaç:
Troid nodulleri dünya çapında oldukça yaygın bir patolojidir. Troıd ince iğne biopsisi(TİİAB) troid malignitelerinin tanısında oldukça önemli bir tanı aracıdır.Ancak sonuçları sınıflandırmak için kullanılan Bethesda Sistemi, hastalar önemi belirlenemeyen atipi/foliküler lezyon belirsiz öneme sahip (AUS / FLUS) nodulun bening veya malign olarak sınıflandıramamaktadır. Bu nedenle bu hastalarda en iyi tedavinin belirlenebilmesi için bazı risk faktörlerinin bilinmesi gerekmektedir. Bu çalışmamızda AUS/FLUS nedeniyle opere edilen hastalarımızı değerlendirmeyi amaçladık.
Gereç ve yöntemler:
Eylül 2018-Aralık 2021 tarihleri arasında TİİAB yapılan 1298 hastadan sitolojisi AUS/FLUS gelen ve opere edilen 144 hastayı retrospektif olarak inceledik.
Bulgular:
TİİAB yapılan sitolojisi AUS/FLUS gelen ve opere edilen 144 hastanın 58 (%40) inin histopatolojisi malign olarak geldi. Troid nodüllerinin ultrasound görüntü özelliklerini malıgn histopatoloji sonuçları ile karşılaştırdığımız zaman hipoekojen,mikrokalsifikasyon,düzensiz sınır ve hipervaskularite görüntülerinin malignite açısından ile anlamlı olduğu tesbit edildi(p<0.005).
Sonuç:
Cerrahi olarak doğrulanan nodüllerde malignite oranı bu çalışmada %40 olup bu oran Bethesda sınıflandırmasına göre yüksek bulunmuştur. Hastalarda TİİAB histopatolojik sonucu AUS/FLUS ile birlikte hipoekoik yapıda, mikrokalsifikasyonlu,düzensiz kenarlı ve hipervasküler nodüller varsa cerrahi tedavinin düşünülmesi gerektiğini düşünüyoruz.

Keywords

Önemi belirsiz atipi, Önemi belirsiz foliküler lezyon, Troid ince iğne biopsisi, Malignansi, Troid nodülü.

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